Vitamin B12 and Disease 
_http://coolinginflammation.blogspot.com/_ 
(http://coolinginflammation.blogspot.com/) 
 
Vitamin B12 and the associated amino acids methionine and  cysteine are 
essential to avoid specific symptoms of anemia and the deleterious  effects of 
inflammation. 
 
Vitamin B12, cobalamin, cannot be made by the human body and  requires a 
protein secreted by stomach cells, intrinsic protein, for uptake from  the diet 
or 
from gut bacteria. In the absence of dietary B12, individuals can  develop 
pernicious anemia. Since vitamin B12 is used by enzymes involved in  nucleic 
acid synthesis, the rapidly dividing cell of the blood show the first  
symptoms. 
Another feature of pernicious anemia is the production of autoimmune  
antibodies against gastric intrinsic protein. This means that even if the diet  
is 
supplemented with vitamin B12, the anemic patient would show no improvement.  
Historically, the cure was beef liver juice containing B12 already bound to  
intrinsic factor. 
 
I enjoyed learning about the autoimmune aspect of pernicious  anemia, because 
when I examined the sequence of the human intrinsic factor, I  found the 
expected pairs of basic amino acids that I associate with strong  heparin 
binding, 
uptake and presentation of allergens. Moreover, the structure  of the protein 
has not yet been determined and intrinsic protein has been called  one of the 
intrinsically unstructured proteins. Proteins with many  heparin-binding 
domains frequently only have a stable shape when bound to  heparin. I would 
predict that pernicious anemia results when intrinsic factor is  presented to 
the 
immune system as a result of inflammation of the stomach or  intestines. 
Subsequently, anti-intrinsic protein antibodies block B12 uptake.  Pernicious 
anemia 
is commonly associated with pathogen attack on stomach tissue  by Helicobacter 
pylori, the stomach ulcer and gastric cancer bacterium.  Treatment for B12 
deficiency has to bypass the required binding to intrinsic  factor and uses 
injection or inhalation of B12 supplements. 
 
There is also a group of proteins that bind to B12 in the  human body and 
apparently block uptake of B12 by pathogens. These proteins are  called “R 
binder”
 proteins and are present in the body in the same pattern as  lactoferrin, an 
antibacterial protein that binds iron, another critical limited  nutrient 
needed by pathogens. 
 
B12 is used by enzymes to hold methyl groups as the groups are  moved from 
one place to another on a substrate molecule. So B12 is needed to  donate a 
methyl group to homocysteine to regenerate the amino acid methionine.  In the 
absence of B12, homocysteine accumulates in the blood and begins to react  with 
the cysteines and lysines of proteins. It is particularly reactive with  enzyme 
active sites and inactivates lysyl oxidase, which cross-links collagen  and 
elastin that are needed for the integrity of heart and smooth muscle. 
 
Inability to regenerate methionine also eliminates the  essential functions 
of its derivative S-adenosylmethionine, SAM, which is  involved in polyamine 
synthesis and cysteine synthesis. Cyseine is an essential  amino acid that is 
one of the three amino acids in glutathione, the major  antioxidant of cells. 
Thus, a methionine deficiency can result in severe  oxidative stress and 
inflammation. 
 
Disruption of normal nutrition, gut flora and uptake can  result in 
deficiencies of vitamin B12, methionine and cysteine, with a  subsequent 
cascade of 
oxidative events leading to inflammation, autoimmunity and  degenerative 
diseases. It seems likely that a similar scenario could be  associated with 
loss of 
physical activity and muscle mass (sarcopenia) of aging.  As the older person’s 
energy requirements decrease, less food will be required,  but the composition 
will need to be adjusted carefully to maintain a healthy gut  flora and avoid 
vitamin and amino acid deficiencies. I would not be surprised if  the diets 
of most older people are grossly inadequate to avoid deleterious  chronic 
inflammation. Poorly managed inflammation could account for most of the  
symptoms 
of aging and its associated degenerative diseases. 
 
On a closing note, alcohol consumption has be associated with  both hangovers 
and decreased risk of cardiovascular disease. The hangovers are  due to 
alcohol conversion to acetaldehyde. Reaction of acetaldehyde with  cysteine may 
be 
both a cure for hangovers and a partial explanation for  increased longevity 
associated with moderate consumption of alcohol. Moderate  and consistent 
alcohol consumption may cause an increase in cysteine storage as  a 
compensation 
for losses due to alcohol intake. If the alcohol adapted person  has higher 
stores of cysteine, there may be a simultaneous increase in cellular  
glutathione 
with a corresponding decrease in oxidative stress and inflammation.  Decrease 
in inflammation is associated with increased longevity. Supplementation  with 
cysteine prior to alcohol consumption eliminates a hangover and may also  make 
you live longer!
 
 
 
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